A Prospective Examination of Antidepressant Use and Its Correlates in Patients With Acute Coronary Syndrome

• Published in: Psychosomatics (Washington, D.C.) D.C.), 2008-05, Vol.49 (3), p.199-207
• Main Authors: Grace, Sherry L., Ph.D, Leung, Yvonne W., M.A, Stewart, Donna E., M.D., FRCPC
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - drug therapy; Acute Coronary Syndrome - epidemiology; Acute Coronary Syndrome - physiopathology; Antidepressive Agents - classification; Antidepressive Agents - therapeutic use; Biological and medical sciences; Demography; Depression - drug therapy; Depression - epidemiology; Depression - psychology; Electrocardiography; Employment - psychology; Employment - statistics & numerical data; Female; Humans; Internal Medicine; Male; Medical sciences; Middle Aged; Neuropharmacology; Pharmacology. Drug treatments; Prospective Studies; Psychiatry; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Retention (Psychology); Sinoatrial Node - physiopathology; Surveys and Questionnaires
• ISSN: 0033-3182; 1545-7206
• DOI: 10.1176/appi.psy.49.3.199

Background Depression has been implicated in the occurrence of recurrent coronary events and cardiac or all-cause mortality in acute coronary syndrome (ACS) patients. Objective The authors describe the frequency and type of antidepressant use and its correlates 18 months after ACS hospital discharge. Method A sample of 661 ACS inpatients, recruited from three hospitals, completed a sociodemographic survey and the Hospital Anxiety and Depression Scale (HADS), and clinical data were extracted from charts. A mailed survey 9 months and 18 months post-discharge assessed self-reported antidepressant use, and the HADS was re-administered. Results Approximately 9% of participants reported antidepressant use both 9 and 18 months post-hospitalization, with 77% concordance in usage over time. Participants most frequently reported using selective serotonin reuptake inhibitors and least often tricyclics. Logistic regression revealed that antidepressant users were more likely to be anxious and have more comorbidity, and were less likely to work full-time, whereas number of medications, age, and marital status were not related. Conclusion Patients with comorbid physical and mental conditions who are unemployed may be more likely to receive an antidepressant because of greater depression symptoms or greater exposure to healthcare providers, which increases the potential for symptom recognition and treatment.